9/13/2002 @ 6:30PM

Why The Rich Live Longer

What is the key to a long life? Philosophers have grappled with that question since they began to opine, but now a growing number of scientists are coming up with a surprising answer of their own: Wealth and success, they say, stave off death. In fact, the strain of not getting them may be what kills us.

The researchers point to decades of data that suggest that those who are higher on the social and economic food chain are also blessed with longer lives. Moreover, many researchers are beginning to reject theories that explain away the difference by noting that those with more money can afford better lives, including better housing, food and health care. Instead, many are turning to a psychological explanation: stress.

“It seemed like a no-brainer initially,” says
Robert
Sapolsky
Robert Sapolsky
, a neurobiologist at Stanford University. “The poor have less access to health care. However, that explanation has gone down the drain.” Sapolsky has become one of the main proponents of the idea that our social and economic position directly affects our susceptibility to any number of diseases, and ultimately the length of our lives.

The evidence for this notion begins more than two decades ago, with a British medical survey of civil servants called the Whitehall Study. All of the people in the study had access to universal medical care and none were impoverished. Still, there was a substantial difference between the life spans of junior and senior employees. Those who made more money, or who had attained higher rank, lived substantially longer. A version of Whitehall is ongoing.

Other studies were done in other populations. Increasingly, many researchers thought they pointed to a single culprit: success. The more money you made, the longer you were likely to live. Furthermore, the difference in life span seemed greatest when income distribution was widest. Put simply, it didn’t so much matter how rich a person was; rather, what was important was how much better he was doing than his neighbors.

“Even if you take the 50 states and control for income distribution, some states are twice as rich as others but don’t have better health,” says
Richard
Wilkinson
Richard Wilkinson
, an epidemiologist at Nottingham Medical School and perhaps the leading thinker in the field. Within each state, however, the richest people seem to live longer than the poorest. To Wilkinson, this is evidence that relative economic rank is what matters in determining how long we live.

More pointedly, it is success–not merely wealth–that is good for people. One eye-catching result: Last year,
Donald
Redelmeier
Donald Redelmeier
, a researcher at the University of Toronto, published a study showing that Academy Award winners live nearly four years longer than actors who were nominated for an award but lost.

There is a problem, though, with drawing these kinds of conclusions from studies of human populations. The data in such research are unavoidably bad, because researchers have little control over their subjects’ lives. Teasing answers from any large population of people is incredibly difficult. To Wilkinson, some of the strongest evidence lies not in studies of people, but in experiments done on monkeys.

Carol
Shively
Carol Shively
, a researcher at Wake Forest University, has spent years studying the impact of social position in the health of macaques. These primates organize themselves into social groups where it is relatively clear which monkeys are dominant and which are submissive. The dominant monkeys live longer, even when access to resources is controlled. Shively also found that if monkeys were forced to change their position in the hierarchy, they all died early. The stress of the change was too much for them–and that was enough to have a large impact on their health.

Perhaps the most radical implication of Wilkinson’s idea is that how we feel about our social and economic status has as great an impact on our health as the latest breakthrough treatment or blockbuster drug. Those at the top of the socioeconomic ladder suffer the least, simply because they are wealthy and they know it. The trend holds true not only for mortality, but also for all but a handful of diseases, including some that cannot be prevented, treated or cured. “Medical care is not yet one of the main determinants of population health,” says Wilkinson.

Not everyone buys into Wilkinson’s big theory. Among his most vocal opponents are a pair of epidemiologists at the University of Michigan,
John
Lynch
John Lynch
and
George
Kaplan
George Kaplan
. “The big argument we have with Richard Wilkinson is that we don’t really believe that this ubiquitous relationship can be explained by psychology. It’s not an issue of how people feel; it’s an issue of what their lives are like,” says Kaplan.

“It would be hard to argue that a millionaire has worse health than a multimillionaire,” Kaplan says. Wilkinson and Sapolsky think you could make the argument, but no studies have been done because the very rich are too few in number. But if they are right, we may get to envy
Bill
Gates
Bill Gates
,
Larry
Ellison
Larry Ellison
and
Warren
Buffett
Warren Buffett
for quite some time to come.